ORDER FORM
PLEASE PRINT THIS ORDER FORM, COMPLETE, AND MAIL
Christie's Daylilies, 6131 Lanes Bridge Road, Jesup, Georgia 31545
FOR PHONE/FAX ORDERS CALL: (912) 586-2273
Name
Address
City
State
Zip
Phone
Email
Shipping Date
May We Subsitute?
Yes
No
click here for shipping charges
METHOD OF PAYMENT
Check Enclosed
PayPal
Visa
Mastercard -- Expiration
Card Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ 3-Digit Security Code___ ___ ___
Signature: ___________________________________________
QTY
CULTIVAR
PRICE
QTY
CULTIVAR
PRICE
1
.
.
.
.
12
.
.
.
.
2
.
.
.
.
13
.
.
.
.
3
.
.
.
.
14
.
.
.
.
4
.
.
.
.
15
.
.
.
.
5
.
.
.
.
16
.
.
.
.
6
.
.
.
.
17
.
.
.
.
7
.
.
.
.
18
.
.
.
.
8
.
.
.
.
19
.
.
.
.
9
.
.
.
.
20
.
.
.
.
10
.
.
.
.
21
.
.
.
.
11
.
.
.
..
.
.
.
.
22
.
.
.
.
.
.
.
.
Gift Certificate Amount
.
Sub-Total
.
10% discount for orders over $300.00
($8.00 PER BOX) Postage
6% or current % sales tax for GA residents
.
TOTAL
.